Gynaecology trainees worldwide find it increasingly difficult to gain the operative experience needed to develop basic and advanced laparoscopic skills. Meanwhile, more and more operations can be performed laparoscopically, and the laparoscopic approach is becoming the gold standard for several 'bread and butter' gynaecological operations: laparoscopic salpingectomy for ectopic pregnancy, bilateral tubal ligation, laparoscopic myomectomy, and laparoscopic hysterectomy to name a few.
Because in vivo training opportunities are increasingly hard to come by, surgical educators must become more innovative in our training techniques and approaches.
There is growing evidence of the construct validity of laparoscopic simulator training: it has been shown to translate well to in vivo operative skills and techniques. The missing link in the chain is how to actually motivate trainees to make the most of the laparoscopic simulation training opportunities available to them. (There is good evidence that relying on trainees' internal motivation is insufficient.)
It is likely that mandatory laparoscopic simulator training will be introduced across Australia and New Zealand in future, so that trainees and trainers alike can use operative time to develop skills and techniques that cannot be learnt in a simulated setting.
I will outline approaches that can be taken to improve trainees' motivation to undertake laparoscopic simulation training, including: inter-specialty competitions (eg. gynaecology vs. general surgery trainees); a structured curriculum of 'box set' laparoscopic training; and proficiency-based simulator training becoming mandatory, prior to being allowed to operate on an actual patient. I will also outline the educational theories behind such approaches, and how they could be implemented locally.